Community Based Rehabilitation, or CBR, is becoming increasingly recognised as an appropriate model of service delivery to provide effective rehabilitation and therapy services to rural and remote communities, with particular relevance for remote and rural Indigenous communities.
In simple terms, CBR refers to the delivery of basic services to disabled people within their community, including all services necessary to improve the participation and functioning in daily activity. More broadly, the UNESCO and WHO define CBR, as:
A strategy within community development for rehabilitation, equalization of opportunities, and social inclusion for all children and adults with disabilities. CBR is implemented through the combined efforts of people with disabilities themselves, their families and communities, and appropriate health, education, vocation and social services.
The basic concept of CBR centres on decentralising responsibility and resources, both human and financial, to community level organisations. CBR models are based on a collaborative relationship between the Allied Health Professional, Community Based Workers and the broader community.
While traditional rehabilitation frameworks tend to be based on a medical model CBR is built on a social, community focused, frameworks. This community orientation is designed to address barriers (medical, social and cultural) that affect a person’s ability to engage in activities and participate in the community, and build the capacity of remote and rural communities.
Benefits of Community Based Rehabilitation
CBR has many benefits for both the clients and the clinician, particularly in remote and rural practice settings. For communities, CBR increases the accessibility of rehabilitation and therapy services for clients. These models increase the services available to people living in rural and remote areas and allow clients to stay in their communities when receiving therapy services.
Additionally, the community development orientation of CBR builds on community capacity and both the individual and community level. At the individual level, CBR models facilitate the training and employment of Community Based Workers, increasing the skills, income, and employability of local community members. At a community level the collaborative relationship between communities and health services empowers communities and develops leadership.
For the clinician, CBR increases the service coverage that can be achieved. It also reduces the frequency of travel to communities, and as a consequence saves time and money.
Community Based Rehabilitation & You
Does your organisation work with CBR models? If so, think about:
- How does CBR change the way services are delivered?
- How does CBR change the relationship between Allied Health Professionals, communities and clients?
- How can CBR enhance your delivery of services?
- Kuipers P, Allen O. Preliminary guidelines for the implementation of Community Based Rehabilitation (CBR) approaches in rural, remote and Indigenous communities in Australia. Rural and Remote Health, vol 4; 2004. Available at: http://www.rrh.org.au.
- Curry R. Allied Health Therapy Services in Aged and Disability Care in Remote Aboriginal Communities of the Northern Territory: A Framework for Quality Service Provision. Top End Division of General Practice. Darwin; 1999.
- Cumaiyi, C. Glynn, R. Community Based Rehabilitation: Relevance for Indigenous Australians in Remote Areas, an investigation. The Winston Churchill Memorial Trust of Australia; 1999.
- Glynn R, Mattiazzo V, Lowell A, Baker L, Lynch A, Wanatjura E. Developing Partnerships between Community Based Workers and Visiting Workers for the Delivery of Aged and Disability Services in Remote Indigenous Communities. Territory Health Service. Darwin; 1999.
- Aboriginal Allied Health Assistant Project (WACHS).